Mechanical Thrombectomy Using Indigo System for the Treatment of Acute Lower Limb Venous Bypass Occlusion

This case series highlights the technical feasibility and the effectiveness of the Penumbra Indigo system in treating vein bypass graft occlusions, with intraoperative success rate of 100% and limb salvage rate of 87.5%.Clinical ImpactThis case series supports the use of the Penumbra Indigo thrombectomy system as a safe, feasible, and effective treatment for acute below-the-knee venous bypass graft occlusions. Rapid mechanical thrombo-aspiration achieved high technical success and favorable short- and mid-term patency rates while minimizing the need for open surgical revision. The ability to perform the procedure under local or loco-regional anesthesia is particularly advantageous in elderly or high-risk patients. These findings highlight the potential of the Indigo system as a frontline or bailout endovascular option to optimize limb salvage and procedural outcomes in complex bypass graft failure.